Quality and safety in the transitional care of the elderly (phase 2): the study protocol of a quasi-experimental intervention study for a cross-level educational programme

Introduction: Transitional care and patient handover are important areas to ensure quality and safety in elderly healthcare services. Previous studies showed that healthcare professionals have little knowledge of the setting they are transferring patients to and a limited understanding of roles and functions; these constitute barriers to effective communication and shared care responsibilities across levels of care. Aim: The main objective is to implement a cross-level education-based intervention programme with healthcare professionals aimed at (1) increasing professionals’ awareness and competencies about quality and safety in the transitional care of the elderly; (2) creating a discussion platform for knowledge exchange and learning across levels and units of care and (3) improving patient safety culture, in particular, in transitional care. Methods and analysis: A quasi-experimental control group study design with an intervention group and a control group; this includes a pretest, post-test and 1-year follow-up test assessment of patient safety culture. Qualitative data will be collected during the intervention programme and between the measurements. The study design will be beneficial for addressing the effects of the cross-level educational intervention programme on reports of patient safety culture and for addressing the feasibility of the intervention measures. Ethics and dissemination: The study has been approved by the Regional Committees for Medical and Health Research Ethics in Norway, Ref. No. 2011/1978. The study is based on informed written consent; informants can withdraw from the study at any point in time. The results will be disseminated at research conferences, in peer review journals and through public presentations outside the scientific community.Norges Forskningsråd: 204637.publishedVersio

Вплив трьох спортивних ігор з фізичного виховання на фізичну підготовленість студентів чоловічої статі

Background and Study Aim. Few controlled studies have been conducted on the effect of sports games as a physical education (PE) course on the health-related fitness of university students. The aim of the study was to determine whether three sports in a PE course will help improve the health-related fitness of male university students. Material and Methods. Students from two universities participated in the study, with one university acting as a control group. There were two PE courses which students registered for: a football and volleyball (FVG, n=169) course and a badminton (BG, n=97) course. The students received basic training drills and competed with one another. The duration of the activities was 50 minutes sessions for eight weeks. The following tests were taken before and after eight weeks: Cooper test, sit-and-reach test, 60-s curl test, standing long jump test, and body mass index. Paired t-tests were used to compare the baseline and post data of each group. The Welch t-test, ANCOVA, and analysis of gains scores were used to compare each of the PE groups to the control group. ANCOVA was used to account for baseline differences, while analysis of gains scores was used whenever ANCOVA could not be used. The Vargha-Delaney Effect Size (VD) and the Common Language Effect Size (CLES) were used to determine the effect sizes for the Welch t-tests and ANCOVA, respectively. Significant changes were set at p ≤ 0.05 and VD ≤ 42% or VD ≥ 58%, or if p ≤ 0.05 and CLES ≥ 58 %. Results.  Both PE groups showed significant improvements in all the measured fitness parameters except body composition. Moreover, the measured parameters of the control group reduced after eight weeks. Conclusion. The study shows evidence that PE courses can serve male universities in improving their health-related fitness. Moreover, students who do not participate in a PE course may be at risk of losing their fitness.Предпосылки и цель исследования. Было проведено мало контролируемых исследований о влиянии спортивных игр в качестве курса по физическому воспитанию (PE) на состояние здоровья студентов университетов. Цель исследования состояла в том, чтобы определить, помогут ли три вида спорта на курсе физического воспитания улучшить состояние здоровья студентов мужского пола.Материал и методы. В исследовании приняли участие студенты из двух университетов, один из которых выступал в качестве контрольной группы. Были два курса физическоого воспитания, на которые зарегистрировались студенты: курс по футболу и волейболу (FVG, n = 169) и курс по бадминтону (BG, n = 97). Студенты проходили базовые тренировки и соревновались друг с другом. Продолжительность занятий составляла 50 минут сеансов по восемь недель. Следующие тесты были взяты до и после восьми недель: тест Купера, тест гибкости, 60-секундный тест сгибания, тест прыжка в длину с места и индекс массы тела. Парные t-тесты использовались для сравнения базовых и пост-данных каждой группы. Для сравнения каждой из групп PE с контрольной группой использовались t-критерий Уэлча, ANCOVA и анализ результатов. ANCOVA использовалась для учета базовых различий, в то время как анализ показателей выигрышей использовался всякий раз, когда ANCOVA нельзя было использовать. Размер эффекта Варга-Делани (VD) и Размер эффекта общего языка (CLES) использовались для определения размеров эффекта для t-тестов Уэлча и ANCOVA, соответственно. Значительные изменения были установлены при p ≤ 0,05 и VD ≤ 42% или VD ≥ 58%, или если p ≤ 0,05 и CLES ≥ 58%.Результаты. Обе группы PE показали значительное улучшение всех измеренных параметров физической формы, кроме состава тела. Более того, измеренные параметры контрольной группы снизились через восемь недель.Выводы. Исследование показывает, что курсы PE могут помочь студентам улучшить свою физическую форму. Кроме того, студенты, которые не участвуют в курсе PE, могут подвергаться риску потерять свою физическую форму.Передумови та мета дослідження. Було проведено мало контрольованих досліджень про вплив спортивних ігор в якості курсу з фізичного виховання (PE) на стан здоров'я студентів університетів. Мета дослідження полягала в тому, щоб визначити, чи допоможуть три види спорту на курсі фізічного виховання поліпшити стан здоров'я студентів чоловічої статі.Матеріал і методи. У дослідженні взяли участь студенти з двох університетів, один з яких виступав в якості контрольної групи. Були два курси фізічного виховання, на які зареєструвалися студенти: курс по футболу і волейболу (FVG, n = 169) і курс з бадмінтону (BG, n = 97). Студенти проходили базові тренування і змагалися один з одним. Тривалість занять складала 50 хвилин сеансів по вісім тижнів. Наступні тести були взяті до і після восьми тижнів: тест Купера, тест гнучкості, 60-секундний тест згинання, тест стрибка в довжину з місця та індекс маси тіла. Парні t-тести використовувалися для порівняння базових і пост-даних кожної групи. Для порівняння кожної з груп PE з контрольною групою використовувалися t-критерій Уелча, ANCOVA і аналіз результатів. ANCOVA використовувалася для обліку базових відмінностей, в той час як аналіз показників виграшів використовувався щоразу, коли ANCOVA не можна було використовувати. Розмір ефекту Варга-Делані (VD) і розмір ефекту спільної мови (CLES) використовувалися для визначення розмірів ефекту для t-тестів Уелча і ANCOVA, відповідно. Значні зміни були встановлені при p ≤ 0,05 і VD ≤ 42% або VD ≥ 58%, або якщо p ≤ 0,05 і CLES ≥ 58%.Результати. Обидві групи PE показали значне поліпшення всіх виміряних параметрів фізичної форми, крім складу тіла. Більш того, виміряні параметри контрольної групи знизилися через вісім тижнів.Висновки. Дослідження показує, що курси PE можуть допомогти студентам покращити свою фізичну форму. Крім того, студенти, які не беруть участі в курсі PE, можуть піддаватися ризику втратити свою фізичну форму

Cross-sectional and longitudinal associations between different exercise types and food cravings in free-living healthy young adults

Introduction: An increase in energy intake due to alterations in hedonic appetite sensations may, at least in part, contribute to lower-than-expected weight loss in exercise interventions. The aim of this study was to examine cross-sectional and longitudinal associations between habitual exercise participation and food cravings in free-living young adults. Methods: A total of 417 adults (49% male, 28 ± 4 years) reported frequency and duration of walking, aerobic exercise, resistance exercise and other exercise at baseline and every 3 months over a 12-month period. Food cravings were assessed via the Control of Eating Questionnaire at baseline and 12-month follow-up. Results: Cross-sectional analyses revealed more frequent cravings for chocolate and a greater difficulty to resist food cravings in women compared to men (p < 0.01). Only with resistance exercise significant sex by exercise interaction effects were observed with favorable responses in men but not in women. Significant main effects were shown for walking and aerobic exercise with exercisers reporting more frequent food cravings for chocolate and fruits and greater difficulty to resist eating compared to non-exercisers (p < 0.05). Longitudinal analyses revealed significant interaction effects for other exercise (p < 0.05) with favorable results in men but not women. Furthermore, significant main effects were observed for aerobic exercise, resistance exercise and total exercise with an increase in exercise being associated with a reduced difficulty to resist food cravings (p < 0.05). Discussion: The association between exercise participation and hedonic appetite sensations varies by exercise type and sex. Even though exercise was associated with more frequent and greater difficulty to food cravings in the cross-sectional analyses, which may be attributed to greater energy demands, longitudinal results indicate beneficial effects of increased exercise on appetite control, particularly in men

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Subcellular distribution of NAD+ between cytosol and mitochondria determines the metabolic profile of human cells

The mitochondrial NAD pool is particularly important for the maintenance of vital cellular functions. Although at least in some fungi and plants, mitochondrial NAD is imported from the cytosol by carrier proteins, in mammals, the mechanism of how this organellar pool is generated has remained obscure. A transporter mediating NAD import into mammalian mitochondria has not been identified. In contrast, human recombinant NMNAT3 localizes to the mitochondrial matrix and is able to catalyze NAD(+) biosynthesis in vitro. However, whether the endogenous NMNAT3 protein is functionally effective at generating NAD(+) in mitochondria of intact human cells still remains to be demonstrated. To modulate mitochondrial NAD(+) content, we have expressed plant and yeast mitochondrial NAD(+) carriers in human cells and observed a profound increase in mitochondrial NAD(+). None of the closest human homologs of these carriers had any detectable effect on mitochondrial NAD(+) content. Surprisingly, constitutive redistribution of NAD(+) from the cytosol to the mitochondria by stable expression of the Arabidopsis thaliana mitochondrial NAD(+) transporter NDT2 in HEK293 cells resulted in dramatic growth retardation and a metabolic shift from oxidative phosphorylation to glycolysis, despite the elevated mitochondrial NAD(+) levels. These results suggest that a mitochondrial NAD(+) transporter, similar to the known one from A. thaliana, is likely absent and could even be harmful in human cells. We provide further support for the alternative possibility, namely intramitochondrial NAD(+) synthesis, by demonstrating the presence of endogenous NMNAT3 in the mitochondria of human cells